Skip to main content
. Author manuscript; available in PMC: 2014 Sep 1.
Published in final edited form as: Infect Dis Clin North Am. 2013 Jul 24;27(3):631–649. doi: 10.1016/j.idc.2013.05.002

Table 2.

Studies of treatment efficacy for STEC O104:H4 infection

Treatment Notes/Results Reference(s)
Meropenam/ciprofloxacin
 (intensive care unit: +
 rifaximin)a 		A significant decrease in mortality, duration of
 STEC excretion in stools (ie, 8 days shorter), and
 incidence of seizures in treated patients, who
 presented with HUS before antibiotic
 treatment		 52
Azithromycinb Used for meningococcal prophylaxis in patients
 with HUS being treated with eculizumab.
 Treatment was associated with a decrease in
 the frequency of long-term O104:H4 carriage		 101
Various antibiotics Study of 24 patients, of whom 7 were treated
 with various antibiotics, including
 ciprofloxacin. 57% of antibiotic-treated
 patients compared with 88% of controls
 developed HUS.		 101
TPE No benefit among 251 patients with HUS who
 underwent TPE vs 47 patients not given TPE,
 but who also had milder disease		 52
TPE 5 patients with HUS with progressive neurologic
 dysfunction who underwent TPE recovered.
 Justification of TPE has been questioned		 120,121
Prednisone + TPE No benefit detected in patients pretreated with
 prednisone before TPE vs TPE alone		 52
Immunoadsorption 12 patients with HUS who developed neurologic
 signs a median of 8 days after enteritis onset
 were treated with multiple courses of
 immunoadsorption. All patients survived and
 10 recovered completely. The rationale for
 treatment was that the late onset of
 neurologic symptoms indicated an
 autoimmune response, but autoantibodies
 were not immunologically validated		 102
Eculizumab One report of 3 children with HUS who
 underwent TPE and eculizumab treatment
 who were reported to have improved
 dramatically		 103
Eculizumab No benefit was conferred to 67 adult HUS
 patients who were treated with eculizumab
 and TPE vs a control group of patients with HUS
 with similar disease severity who were treated
 with TPE but not eculizumab		 52
a

Some patients who were admitted to the intensive care unit were also treated with rifaximin.

b

Short-course azithromycin was recently shown to be associated with sudden cardiac death.122 Because ~10% of HUS mortality may result from cardiac arrhythmias, it has been argued that azithromycinc should not be used to treat patients with HUS.123